Lower the risk of 'wear and tear' arthritis in later life by adopting this expert-approved strategy. Photo / Getty Images
As we head into middle age and beyond it seems none of us will be immune to joint problems.
According to Versus Arthritis, a UK charity, 10 million Brits suffer regular joint pain. This is mostly osteoarthritis (often called "wear and tear" arthritis), which often afflicts weight-bearing joints such as hips, knees, spine and toes.
Osteoarthritis is caused by the cushioning cartilage in our joints breaking down, leaving the underlying bone prone to damage. The result is pain, stiffness, swelling and grating. Risk rises with age, with around a third of people over the age of 60 having knee osteoarthritis.
How do we keep this dread visitation at bay? The temptation is to stay home and give our creaking bones an easy time. All the latest science says the opposite.
Regular walks can ward off knee pain for over-50s with knee osteoarthritis, says new research published earlier this month in the journal Arthritis & Rheumatology.
A four-year study of more than 1000 people found that among those who don't walk for exercise, more than a third suffered frequent knee pain, compared with only a quarter of regular walkers. The walkers also suffered less physical damage to knee joints.
"This study highlights the importance of good old exercise," says Dr Grace Hsiao-Wei Lo, the lead researcher, and an assistant professor of immunology, allergy and rheumatology at Baylor College of Medicine, Houston. The research suggests that walking may also help to manage osteoarthritis in hips and feet because it builds supportive muscle and strengthens ligaments.
Meanwhile, more energetic midlifers can keep on running – so long as there's no pain. In March, a study in the British Journal of Sports Medicine revealed recreational running does not necessarily harm knee cartilage.
But vigorous high-impact sports, such as football, rugby and netball, are best avoided by most midlifers, says Ian McDermott, a consultant knee surgeon at London Sports Orthopaedics.
"People persist despite starting to get niggling pains, thinking they can overcome them. But those pains mean you're heading towards osteoarthritis," he says. "It's time to take up something gentler on joints such as walking, swimming or cycling."
2. Try tai chi or yoga
A 16-week study of 50 volunteers aged over 60 in The Journal of Sports Medicine and Physical Fitness found that while both exercise regimes helped with general movement and coordination, tai chi was better at strengthening knees and hips.
"Gentle strengthening exercises are strongly recommended. The key is generally to stay fit and healthy," says Deborah Eastwood, a consultant orthopaedic surgeon and president-elect of the British Orthopaedic Association.
"What's great for your health is best for your joints," she says. "That means good habits such as staying off the sofa and avoiding chips, chocolates and smoking."
3. Wear sturdy flats
Your footwear can be crucial joint protectors, according to a six-month study of more than 160 people. Physiotherapists at the University of Melbourne, Australia asked volunteers aged over 50 to wear either supportive shoes with thick soles that didn't bend much, or flat shoes with thin, flexible soles, for six hours a day.
Some experts believe flexible soles help protect joints by allowing more natural movement of the leg and foot. However, the study in last year's Annals of Internal Medicine reported that 60 per cent of people in the supportive shoe group enjoyed reduced knee pain, compared with only 40 per cent of those who wore flat, flexible footwear. Flexible wearers, the study found, were twice as likely to develop ankle or foot pain.
If you're wearing running shoes, trendy ones with heels can increase pain compared with completely flat (though highly supportive) ones, reports another study, published in March by investigators at the University of North Carolina at Chapel Hill. They warn in the journal Gait & Posture that heeled running shoes make the knee bend more, which puts increased stress on the joint.
4. Ditch the fast food
Tucking into convenience foods on a regular basis may speed the deterioration of joints by causing chronic inflammation. The problem is that foods such as ready meals and pizza are high in industrial fats that promote the growth of toxic bugs in our guts, researchers at the University of Rochester, New York, warn.
Their studies on lab mice found the toxic bacteria caused chronic inflammation throughout the rodents' bodies, leading to rapid joint deterioration.
Changing one's diet will help, but the researchers also reported in the journal JCI Insight in 2018 that consuming probiotic bacteria, such as the common yoghurt additive Bifidobacteria, seemed to help keep toxic bugs at bay, even in convenience-food consumers.
However, as for taking costly supplements that promise to "boost" joint health or even regenerate cartilage, don't bother, says McDermott: "None of them work. The supplement industry is a multi-billion-pound con," he says. "The only one worth taking regularly is vitamin D for bone strength because so many of us in Britain are deficient. Eating a healthy fresh diet with regular oily fish is the best thing you can do."
5. Watch your weight
Being overweight or obese is reported to be the "largest modifiable risk factor" for joint problems such as osteoarthritis and knee, hip and ankle pain, according to Versus Arthritis.
Carrying just 7lb of extra weight can mean an added 30lb of pressure on your knees and other lower body joints as you walk. Extra weight also puts an additional load on your spinal discs, which can lead to back pain.
A study of more than 2500 volunteers in the journal Arthritis & Rheumatism found a strong link between people with a high body mass index and disc degeneration in people with joint pain in their lower backs. The researchers also suggested fat cells may exacerbate the problem by causing chronic skeletal inflammation.
6. Treat yourself to moderate tipples
The Queen reportedly gave up one of her treats – an evening dry martini – last year on the advice of doctors who warned it may be bad for her joints.
In fact, scientists are still fathoming alcohol's effects. A study of 2000 Brits aged over 45 found that while drinking beer seems to increase the risk of joint problems in knees and hips, moderate wine consumption might actually lower the risk of developing knee osteoarthritis.
Moderation certainly appears to be key, say experts at the Arthritis Foundation charity. "While moderate drinking may reduce some risks of developing arthritis, if you already suffer from arthritis or a condition like gout, it may do more harm than good."
7. Keep feeling positive
"Do everything you can to keep your moods happy, not least for the sake of your joints," says Eastwood. "Research suggests low mood exacerbates people's experience of arthritic pain. This can put them off exercising. Sedentariness worsens pain levels and restricts physical flexibility, so people exercise less. It all becomes a vicious spiral.
"If you can maintain a positive mental attitude then your ability to cope with aches and pains is improved," she adds. "As a consequence, you get out and enjoy an active social life and get the joint-fostering benefits that gentle exercise brings."